Provision of health services for elderly populations in rural and remote areas in Australia: A systematic scoping review.
Australia
aged care
elderly population
health services
healthy ageing
rural and remote
service provision
Journal
The Australian journal of rural health
ISSN: 1440-1584
Titre abrégé: Aust J Rural Health
Pays: Australia
ID NLM: 9305903
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
18
06
2023
received:
01
02
2023
accepted:
03
07
2023
medline:
23
10
2023
pubmed:
20
7
2023
entrez:
20
7
2023
Statut:
ppublish
Résumé
Although various studies have examined availability, access barriers and patient experiences of rural health services for the ageing population, no synthesis of this literature exists in Australia. The objective of this study was to examine the current literature surrounding rural service provision and to evaluate the barriers to access for older individuals and to recognise gaps in the literature. A systematic scoping review of peer-reviewed literature from three online databases (PUBMED, SCOPUS and Web of Science). Thirty-two papers were included in analysis. The most prominent types of health service discussed were residential aged care (n = 12) and community health care (n = 10). More studies explored the perspectives of health personnel than the service end users. Qualitative synthesis revealed three themes associated with health service and rural ageing: access to services, health workforce experiences and end user experiences. Access to health services for the elderly population is a complex issue. Promoting positive experiences for both health providers and patients is critical to assisting in healthy ageing for people living in rural and remote areas. This requires intervention on a social and institutional level. Key research gaps in the literature include the effectiveness of an integrated approach to institutional interventions, utilisation of preventative measures such as screening programs for cancer and greater identification of the health needs and perceptions among culturally diverse elderly residents. These studies are critical to promote appropriate and patient-centred care for elderly populations in rural and remote areas. The review highlights the need to address availability, retention and service innovations across health services to improve access to care and health outcomes of rural elderly residents.
Types de publication
Systematic Review
Journal Article
Review
Langues
eng
Pagination
805-825Informations de copyright
© 2023 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
Références
Australian Bureau of Statistics. Disability, ageing and carers, Australia: summary of findings. Canberra, ACT: Australian Bureau of Statistics; 2018. Available from: https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/latest-release
Australian Institute of Health and Welfare. Older Australians living in rural and remote communities. Canberra, ACT: Australian Institute of Health and Welfare; 2021. Available from: https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/diverse-groups-of-older-australians/regional-remote-communities
Wilson T, Temple J. New population projections for Australia and the States and Territories, with a particular focus on population ageing. ARC Centre of Excellence in Population Ageing Research (CEPAR) working paper 2022/11. 2022. Available from: https://cepar.edu.au/file/3431/download?token=33d-oPn3
Australian Bureau of Statistics. Population projections Australia 2017-2066. Canberra, ACT: Australian Bureau of Statistics; 2018. Available from: https://www.abs.gov.au/statistics/people/population/population-projections-australia/2017-base-2066
Australian Institute of Health and Welfare. Older Australians. Canberra, ACT: AIHW; 2021. Available from: https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile
Davis S, Bartlett H. Review article: healthy ageing in rural Australia: issues and challenges. Australas J Ageing. 2008;27(2):56-60. https://doi.org/10.1111/j.1741-6612.2008.00296.x
Davis J, Morgans A, Stewart J. Developing an Australian health and aged care research agenda: a systematic review of evidence at the subacute interface. Aust Health Rev. 2015;40(4):402-427. https://doi.org/10.1071/AH15005
van Gaans D, Dent E. Issues of accessibility to health services by older Australians: a review. Public Health Rev. 2018;39:20. https://doi.org/10.1186/s40985-018-0097-4
Royal Commission into Aged Care Quality and Safety. Final report: care, dignity and respect - volume 1: summary and recommendations. Canberra, ACT: The Royal Commission into Aged Care Quality and Safety; 2021. Available from: https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-volume-1_0.pdf
Hussain R, Janicki MP, Knox M, Wark S, Parmenter T. Perspectives about support challenges facing health workers assisting older adults with and without intellectual disability in rural versus urban settings in Australia. J Intellect Dev Disabil. 2019;44(2):174-183. https://doi.org/10.3109/13668250.2017.1326589
Savy P, Warburton J, Hodgkin S. Challenges to the provision of community aged care services across rural Australia: perceptions of service managers. Rural Remote Health. 2017;17(2):4059. https://doi.org/10.22605/rrh4059
Mitchell G, Nicholson C, McDonald K, Bucetti A. Enhancing palliative care in rural Australia: the residential aged care setting. Aust J Prim Health. 2011;17(1):95-101. https://doi.org/10.1071/py10054
Goel K, Penman J. Employment experiences of immigrant workers in aged care in regional South Australia. Rural Remote Health. 2015;15(1):2693. https://doi.org/10.22605/RRH2693
Annear MJ, Lucas P. Dementia in a regional hospital setting: contextual challenges and barriers to effective care. Int J Ageing Later Life. 2018;12(1):91-119. https://doi.org/10.3384/ijal.1652-8670.17344
Handley T, Perkins D, Kay-Lambkin F, Lewin T, Kelly B. Familiarity with and intentions to use internet-delivered mental health treatments among older rural adults. Aging Ment Health. 2015;19(11):989-996. https://doi.org/10.1080/13607863.2014.981744
Muir-Cochrane E, Okane D, Barkway P, Oster C, Fuller J. Service provision for older people with mental health problems in a rural area of Australia. Aging Ment Health. 2014;18(6):759-766. https://doi.org/10.1080/13607863.2013.878307
Tham R, Hardy S. Oral healthcare issues in rural residential aged care services in Victoria, Australia. Gerodontology. 2013;30(2):126-132. https://doi.org/10.1111/j.1741-2358.2012.00652.x
Radermacher H, Feldman S. 'Health is their heart, their legs, their back': understanding ageing well in ethnically diverse older men in rural Australia. Ageing Soc. 2015;35(5):1011-1031. https://doi.org/10.1017/S0144686X14001226
Bell D, Lindeman MA, Reid JB. The (mis)matching of resources and assessed need in remote aboriginal community aged care. Australas J Ageing. 2015;34(3):171-176. https://doi.org/10.1111/ajag.12164
Parrella A, Pearson O, Davy C, Barrie H, Mott K, Morey K, et al. Understanding culturally safe aged care from the perspectives of older aboriginal Australians in rural and remote communities. Health Promot J Austr. 2021;33(3):566-575. https://doi.org/10.1002/hpja.541
Australian Institute of Health and Welfare. Metadata online registry: visiting medical officer. Canberra, ACT: AIHW; 2018. Available from: https://meteor.aihw.gov.au/content/index.phtml/itemId/327170#:~:text=Definition%3A,or%20fee%20f
Paliadelis P, Parmenter G, Parker V, Giles M, Higgins I. The challenges confronting clinicians in rural acute care settings: a participatory research project. Rural Remote Health. 2012;12:2017. https://doi.org/10.22605/RRH2017
Munn Z, Peters MD, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):1-7. https://doi.org/10.1186/s12874-018-0611-x
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473. https://doi.org/10.7326/m18-0850
Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141-146. https://doi.org/10.1097/xeb.0000000000000050
Taylor D, Barrie H, Lange J, Thompson MQ, Theou O, Visvanathan R. Geospatial modelling of the prevalence and changing distribution of frailty in Australia-2011 to 2027. Exp Gerontol. 2019;123:57-65. https://doi.org/10.1016/j.exger.2019.05.010
Henderson J, Dawson S, Fuller J, O'Kane D, Gerace A, Oster C, et al. Regional responses to the challenge of delivering integrated care to older people with mental health problems in rural Australia. Aging Ment Health. 2018;22(8):1025-1031. https://doi.org/10.1080/13607863.2017.1320702
Ervin K, Reid C, Moran A, Opie C, Haines H. Implementation of an older person's nurse practitioner in rural aged care in Victoria, Australia: a qualitative study. Hum Resour Health. 2019;17:80. https://doi.org/10.1186/s12960-019-0415-z
Pierce D, Fraser G. An investigation of medication information transfer and application in aged care facilities in an Australian rural setting. Rural Remote Health. 2009;9(3):1090. https://doi.org/10.22605/RRH1090
Lam L, Ansari AS, Baquir PJ, Chowdhury N, Tran K, Bailey J. Current practices, barriers and enablers for advance care planning among healthcare workers of aged care facilities in western New South Wales, Australia. Rural Remote Health. 2018;18(4):4714. https://doi.org/10.22605/rrh4714
Wellard SJ, Rasmussen B, Savage S, Dunning T. Exploring staff diabetes medication knowledge and practices in regional residential care: triangulation study. J Clin Nurs. 2013;22(13-14):1933-1940. https://doi.org/10.1111/jocn.12043
Bernoth MA, Dietsch E, Davies C. Forced into exile: the traumatising impact of rural aged care service inaccessibility. Rural Remote Health. 2012;12(1):1924. https://doi.org/10.22605/RRH1924
Marino RJ, Khan AR, Tham R, Khew CW, Stevenson C. Pattern and factors associated with utilization of dental services among older adults in rural Victoria. Aust Dent J. 2014;59(4):504-510. https://doi.org/10.1111/adj.12216
Department of Health and Aged Care. $17.7 billion to deliver once in a generation change to aged care in Australia (media release). Canberra, ACT: Department of Health and Aged Care; 2021. Available online from: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/177-billion-to-deliver-once-in-a-generation-change-to-aged-care-in-australia
Dent E, Hoon E, Karnon J, Newbury J, Kitson A, Beilby J. Frailty and health service use in rural South Australia. Arch Gerontol Geriatr. 2016;62:53-58. https://doi.org/10.1016/j.archger.2015.09.012
Evans R, Larkins S, Cheffins T, Fleming R, Johnston K, Tennant M. Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland. Aust J Prim Health. 2017;23(2):114-122. https://doi.org/10.1071/py15175
Dudgeon P, Howe AL. Monitoring regional geriatric assessment teams: analysis of client flows and outcomes. Community Health Stud. 1989;13(2):200-210. https://doi.org/10.1111/j.1753-6405.1989.tb00198.x
Lester D, Tiedemann A, Sherrington C. Objectively measured mobility of rural community-dwelling people aged 80 and over is strongly associated with greater use of services for community integration and social support: an observational study. Aust J Rural Health. 2019;27(1):6-13. https://doi.org/10.1111/ajr.12438
Knight BG, Winterbotham S. Rural and urban older adults' perceptions of mental health services accessibility. Aging Ment Health. 2020;24(6):978-984. https://doi.org/10.1080/13607863.2019.1576159
Giles LC, Halbert JA, Crotty M, Cameron ID, Gray LC. The distribution of health services for older people in Australia: where does transition care fit? Aust Health Rev. 2009;33(4):572-582. https://doi.org/10.1071/ah090572
Dai Z, Raban MZ, Sezgin G, McGuire P, Datta S, et al. Opioid prescribing among aged care residents during the first year of the COVID-19 pandemic: an analysis using general practice health records in Australia. BMC Geriatr. 2023;23(1):111. https://doi.org/10.1186/s12877-023-03821-5
George M, Smith A, Ranmuthugula G, Sabesan S. Barriers to accessing, commencing and completing cancer treatment among geriatric patients in rural Australia: a qualitative perspective. Int J Gen Med. 2022;15:1583-1594. https://doi.org/10.2147/ijgm.s338128
Gillespie R, Mullan J, Harrison L. Factors which influence the de-prescribing decisions of community-living older adults and GPs in Australia. Health Soc Care Community. 2022;30(6):e6206-e6216. https://doi.org/10.1111/hsc.14058
Jadczak AD, Robson L, Cooper T, Bell JS, Visvanathan R. The Frailty In Residential Sector over Time (FIRST) study: methods and baseline cohort description. BMC Geriatrics. 2021;21:99. https://doi.org/10.1186/s12877-020-01974-1
McManamny TE, Dwyer R, Cantwell K, Boyd L, Sheen J, et al. Emergency ambulance demand by older adults from rural and regional Victoria, Australia. Australas J Ageing. 2021;41(1):e74-e81. https://doi.org/10.1111/ajag.12960
Naweed A, Stahlut J, O'Keeffe V. The essence of care: versatility as an adaptive response to challenges in the delivery of quality aged care by personal care attendants. Hum Factors. 2022;64(1):109-125. https://doi.org/10.1177/00187208211010962
Pearson R, Mullan J, Dijkmans-Hadley B, Halcomb E, Bonney A. Medical care in Australian residential aged care: perspectives of residents, family, nurses and general practitioners. Health Soc Care Community. 2021;29(6):e279-e287. https://doi.org/10.1111/hsc.13352